Monofocal IOL for NEAR: How far can you see?

michael74313, I totally agree about the liability.  I would have the same reservation if I were the surgeon, since results are never guaranteed and I wouldn't want to be in a position of a patient saying "you said I would see X . . .," especially since it is an elective surgery with inherent risks.  I guess sharing anecdotes here does serve a purpose; to report some "best-case" scenarios (along with the worst) without fear of liability.

michael74313 can I ask you and all other people posting here with excellent monofocal results with both eyes set for distance to identify the make of their monofocal IOLs?  Please include the brand, model, and if at all possible the power of the lens selected (in Diopters).  I am asking this because some monofocal models (e.g.Bausch & Lomb FOCUSforce aspheric) tout their "aberration-free optic provides great depth-of-field".  The excellent results achieved by nina234 and a few others here may be related to the

choice of brand/model of monofocal lens.  While all monofocals are similar in function, they are not all identical in their finer features.  You have to read at a deeper level in comparison studies related to depth of field, corneal and lens aberration, etc. to appreciate these subtle and very significant differences.

 

Just a word of caution!

Different persons with very similar vision may describe it as good, very good, excellent or superb. Even a 20/25 vision may be considered excellent by someone who has not been able to see clearly for years due to cataracts. Giving a value such as 20/25, 20/20 etc can help a little, but even then there are other aspects of clear or good vision, which is not covered by reading a chart.

I wondered the same thing.  Thanks for providing a word of caution.   Expectations play a part too and what someone considers tolerable with night vision halos is horrendous for someone else when looking at EDOF or multifocal lenses so it stands to reason that monofocals providing depth of field might mean different things to different people.  In my discussion with opthamologist he didn’t give provide any sense of comfort that one would be able to read with monofocals without some sort of mini or full

monovision.

On Jan 16 I had a Tecnis monofocal implanted in LE (dominant) and set for distance with excellent results - 20/20, myopia and astigmatism at plano.  The surgeon hit the target. Crystal clear, sharp vision at distance with vibrant colours.  Intermediate vision (24-32 inches) is blurry

and not sufficient to work on the computer.  My RE is scheduled next week. Planning to do the same IOL for distance. Assuming an excellent outcome with the RE should I expect with both eyes working together that my intermediate vision will improve enough to enable me to work comfortably at my computer?  One more question for Michael - why would a 1/2 diopter tweak help your reading?  1/2 diopter amounts to a focal point of 2 meters (78 inches) which is way too far for reading or computer work.  My surgeon indicated that I would need -1.25D to achieve clear intermediate vision.  

 

I wouldn't count on decent intermediate (computer) distance vision with both eyes at PLANO good distance vision.  My right eye with the Tecnis toric monofocal reached the target of 0D to -0.25D with less than 0.5D cylinder residual astigmatism, and I need +0.75D to +1.00D glasses to get good computer distance vision 24 to 36 inches.  So I plan whenever I get my left eye done some years in the future to probably have it targetted for -0.75D to -1.00D for mini-monovision, either that or a Symfony Toric IOL which should provide effective a 1.50D focus range.  -1.25D might be better for reading a smartphone at about 20 to 24 inches however.

I agree with Night-Hawk's suggestion. If you want to be able to have good intermediate distance vision using both eyes, you should have the IOL for the second eye set for about -1.0 D or -1.25D. You should not have any problem adjusting to this mini-monovision. If this lens is monofocal, similar to the first one, you will still need glasses for reading fine print at close distances, but you will not need them for working at 24 - 30 inches distance from a computer screen.

On Jan 23 I had a Tecnis monofocal implanted in RE (non-dominant) set to -1.50D to have near and intermediate vision without correction. One day post-op RE at 20/80 and no astigmatism.  

Binocular distance vision excellent.  Binocular intermediate vision (24-32" improving but not quite as clear as I need it.  Binocular near vision clear at about 16

LE at 10 days post-op holding at 20/20 and no astigmatism.

Am glad that you had a successful surgery without any complications. Am sure that it is a big relief to you.

Your RE will be changing a little over the next month, but at the moment, it appears that your lens in the RE ended up being set at about -2.25D (instead of the target of -1.5D). Fortunately, you will find that with the combination you are ending up with, you will get used to it quite fast.  I was using a similar combination as you for years with contact lens without any significant issue (in spite of the less-than-desirable intermediate distance vision) without using any glasses.

Thank you.  Yes, quite relieved.  Now to allow time for healing and make the best of it.  I have not used eyeglasses since my second eye (RE) was operated.  I just hope my intermediate vision improves to make working on the computer less of a struggle.

If by the time of my next exam (Feb 28) my intermediate vision is not up to par for long term computer work, what are my options to boost it?  I do not want to use contact lens(es).

If you find that you have problem working on the computer without using the glasses (you may not), you can have a slight adjustment or correction by using LASIK (or PRK). I have had such LASIK adjustments for both of my eyes and am very glad that I did.

The doctor will probably want you to wait 3months+ after surgery before any other work on that eye.  It can still be healing for up thru 3months+ and the vision can still vary during that time.

At your next exam, see if they will do an auto-refraction to see about where that eye ended up for power and cylinder. But might need a full optometrist refraction when the eye has stabilized to really determine how far it is off from your target and find out if it can be corrected first with simple weak reading glasses for near and intermedate vision.

According to a "Conversion Chart: Refractive State to "estimated" Visual Acuity" chart on the web, 

VA acuity of 20/70 amounts to -1.25D and 20/100 to -1.50D.  In rough math 20/80 is about -1.30D.

That gives a focal point of 77cm or 30in.  The surgeon's RE target was -1.50D (mini monovision).

At 30in I can read my computer screen without magnifying the font but with a touch of blurriness.

I wear varilux for 20 yrs and dr said I will do fine with the standard implant. How do,you see intermediate like looking at the radio stations in your car. Can u still drive at night and see clearly. Help!.. Hope to hear your experience